NPIMap

Organization Active NPI

Empower Licensed Behavior Analyst PLLC

  • Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1124624697
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EMPOWER LICENSED BEHAVIOR ANALYST PLLC
Practice address
5213 19TH Ave
Brooklyn, NY 11204-1602
Phone
(718) 702-7693
Fax
(718) 387-6429
NPI assigned
Dec 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Peri E Goldwurm, BA
Title
Ceo
Phone
(718) 702-7693

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

5213 19TH Ave
Brooklyn, NY 11204-1602

Mailing address

5213 19TH Ave
Brooklyn, NY 11204-1602
Phone (718) 702-7693

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1124624697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5213 19TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041602",
            "telephone_number": "718-702-7693",
            "fax_number": "718-387-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5213 19TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041602",
            "telephone_number": "718-702-7693",
            "fax_number": "718-387-6429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWER LICENSED BEHAVIOR ANALYST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "GOLDWURM",
        "authorized_official_first_name": "PERI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-702-7693",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.